KOCHI: A flat foot or loss of arch in foot isn’t an unusual condition. In this case, the arch is lower than typical, resulting in the entire foot making contact with the ground. While many have flat feet without any issues, others may experience pain and discomfort, especially during physical activities.
It is important to note that we are all born with flat feet. The arches typically develop as we grow. The arch in a child usually develops by 6-7 years of age. However, parents often get worried about the condition in the infant stage and bring their kids asking for evaluations and solutions for flat feet.
One of the common reasons for this condition especially in children is genetic. However, these are usually flexible flat feet and painless, and the treatment for the same is done generally to educate the family and supervise any progress of pain.
In certain conditions like cerebral palsy or any neuromuscular disorder, flat feet can be painful and would require proper evaluation and at times surgery.
There are a few cases in children, where flat foot deformity is quite severe with the heel pointing grossly outside. These children would experience difficulty walking fast and at times pain. In such situations, customised footwear might bring some relief. However, a more effective alternative is keyhole surgery. This procedure involves placing a metal stent to help the feet get back to normal shape.
Among adults, flat feet are a painful condition which is unfortunately ignored or mismanaged.
There are varied causes of flat feet development in adults. This includes injury/fracture to the foot, disease involving the tendon and ligaments of the foot, arthritic conditions, diabetes, obesity etc. The treatment is quite individualised. While many practitioners recommend arch-support footwear for adults, numerous studies have shown that this approach is often ineffective. Instead, a fully customised insole is essential.
Symptoms
Many individuals with flat feet experience few to no symptoms. However, some common signs include pain, swelling along the inside of the ankle, and difficulty in standing on tiptoes.
If such symptoms prevail, it is essential to consult an orthopaedic surgeon, especially a foot and ankle surgeon. The diagnosis is made with a good physical examination of the feet and legs with a review of your medical history and also through weight-bearing X-rays. In certain situations, MRI can also assess the problem.
Treatment Options
While flat feet can’t always be prevented, there are ways to promote foot health like wearing the right footwear, staying active with good toning of foot, ankle and calf muscles and maintaining adequate body weight. Treatment for flat foot varies depending on the age, underlying cause and severity of the condition:
Conservative Management
Footwear along with customised insoles gives adequate support to the foot and it can significantly alleviate discomfort. Additionally, strengthening exercises for the foot and leg muscles can help improve arch support and reduce pain. For flat feet, medications do not have a role, other than painkillers.
Surgical Options
If the conservative management proves ineffective, then surgery is the mainstay of treatment. In children, a minor surgery may be needed but in adults, the realignment of bone, tendon and muscles is required. Today with a better understanding of the biomechanics of the foot, a good surgical reconstruction of the flat foot is seen as an effective solution. With the right treatment management strategies and proactive care, one can keep their feet healthy and functional for years to come.
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